一项回顾性研究:胸腔镜肺叶切除术和节段切除术治疗早期非小细胞肺癌的疗效。

A Retrospective Study of Effectiveness of Thoracoscopic Lobectomy and Segmentectomy in Patients with Early-Stage Non-Small-Cell Lung Cancer.

机构信息

Department of Cardiothoracic Surgery, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, Yancheng 224000, China.

出版信息

Dis Markers. 2022 Apr 28;2022:6975236. doi: 10.1155/2022/6975236. eCollection 2022.

Abstract

BACKGROUND

Surgical treatment is the first choice for non-small-cell lung cancer. To date, there are only few studies on the changes in laboratory indexes in two types of surgery, namely, thoracoscopic lobectomy and segmental pneumonectomy.

AIM

To investigate the clinical impact of thoracoscopic lobectomy and segmentectomy in patients with early-stage non-small-cell lung cancer.

METHODS

We retrospectively reviewed the medical records of 94 patients with early-stage NSCLC in our hospital from October 2017 to October 2019. The patients were divided into two groups. The patients in control and observation groups received thoracoscopic lobectomy and thoracoscopic segmentectomy, respectively. The perioperative indicators, complications, lung function, T cell subsets, tumor markers, follow-up of tumor recurrence rate, and survival rate were compared between two groups.

RESULTS

The operation time of the observation group was longer, and the chest drainage volume was less at 24-48 h after the operation, and the chest tube indwelling time and postoperative hospital stay were shorter than those of the control group. No significant differences in complication probability were observed between two groups. The levels of FEV1, FVC, and MVV in the two groups were lower than those before the operation at 3 days after surgery, but the FEV1, FVC, and MVV levels in the observation group were higher than those in the control group. The CD3+, CD4+, and CD4+/CD8+ levels in the two groups were lower than those before the operation at 24 h and 72 h after the operation, but CD3+, CD4+, and CD4+/CD8+ levels in the observation group were higher than those of the control group.

CONCLUSION

Thoracoscopic lobectomy and segmental resection have similar clinical effects in the treatment of early-stage NSCLC patients, but segmental resection can preserve healthy lung tissue as much as possible, with less trauma, protect lung function, and promote postoperative recovery.

摘要

背景

手术治疗是非小细胞肺癌的首选方法。迄今为止,仅有少数研究探讨了两种手术类型(电视辅助胸腔镜肺叶切除术和节段切除术)的实验室指标变化。

目的

探讨电视辅助胸腔镜肺叶切除术和节段切除术治疗早期非小细胞肺癌的临床效果。

方法

回顾性分析我院 2017 年 10 月至 2019 年 10 月收治的 94 例早期非小细胞肺癌患者的病历资料。将患者分为两组,对照组和观察组患者分别接受电视辅助胸腔镜肺叶切除术和电视辅助胸腔镜节段切除术。比较两组患者的围手术期指标、并发症、肺功能、T 细胞亚群、肿瘤标志物、肿瘤复发率和生存率。

结果

观察组患者的手术时间较长,但术后 24-48 小时的胸腔引流量较少,胸腔引流管留置时间和术后住院时间均短于对照组。两组患者的并发症发生率差异无统计学意义。两组患者术后第 3 天的 FEV1、FVC 和 MVV 水平均低于术前,但观察组患者术后第 3 天的 FEV1、FVC 和 MVV 水平高于对照组。两组患者术后第 24 小时和第 72 小时的 CD3+、CD4+和 CD4+/CD8+水平均低于术前,但观察组患者术后第 24 小时和第 72 小时的 CD3+、CD4+和 CD4+/CD8+水平高于对照组。

结论

电视辅助胸腔镜肺叶切除术和节段切除术治疗早期非小细胞肺癌的临床效果相似,但节段切除术可以尽可能保留健康的肺组织,创伤较小,保护肺功能,促进术后恢复。

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